NPIMap

Organization Active NPI

Novant Medical Group Inc

Doing business as Novant Health Cherokee Urology

  • Urology Physician
  • Gaffney, SC
National Provider Identifier
1053658526
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
NOVANT MEDICAL GROUP INC
Doing business as
Novant Health Cherokee Urology
Practice address
1506 N Limestone St
Suite D
Gaffney, SC 29340-4747
Phone
(864) 489-6864
Fax
(864) 489-1477
NPI assigned
Jan 3, 2013
Last updated
Jan 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Geoffrey Keith Gardner
Title
VP Finance
Phone
(704) 384-9094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X Primary

Addresses

Primary practice location

1506 N Limestone St
Suite D
Gaffney, SC 29340-4747

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other names 1

  • Novant Health Cherokee Urology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061212000240 SC Part B Supplier - Clinic/Group Practice 1153234893 Receives reassigned benefits from 23 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Mill, SC; Indian Land, SC

Other NPIs on the same Medicare enrollment 37

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 37

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358467200000",
    "number": "1053658526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 N LIMESTONE ST",
            "address_2": "SUITE D",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293404747",
            "telephone_number": "864-489-6864",
            "fax_number": "864-489-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVANT MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-18",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "704-384-9094",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Novant Health Cherokee Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaffney, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.